COMPLICATION RATES IN CATARACT SURGERY – FIRST 500 CATARACT CASES AS A RESIDENT DOCTOR

This surgical audit was performed to assess, analyze and represent, the complications that occurred during author’s first 500 cataract surgeries as a resident in ophthalmology. The study covers the period from April 9-2024 to October 2-2025, and includes detailed date on patient demographics, ocular characteristics, surgical variables, and postoperative outcomes. The primary objective of this audit is to determine the incidence, types, and timing of surgical complications during this initial period, with the aim of understanding how complication pattern changes as surgical experience evolves.  

Type of Surgery and Phacoemulsification, Demographics & Surgical Characteristics, Age Distribution, Gender Distribution, Eye Operated (OD vs OS), Cataract Types,Co-existing Pathologies,Mydriasis Types,Incision Types,Incision Location,IOL Type Distribution,IOL Diopter Distribution,IOL Location,Pre-operative Visual Acuity,Post-operative Visual Acuity,All Complications – Overview,Posterior Capsular Rupture,Incomplete capsulorhexis,Vitreous loss,Iris Prolapse,Suture & Incision,complication summary

Clinical audit of 500 patients operated for cataract surgery from a resident doctor. 

Comprehensive Intraoperative Complication Analysis (Sections T–AW, n = 500 cases) ,A total of 28 distinct intraoperative complication categories were analyzed across 500 cataract surgeries. Suture 10.0 Nylon (7.8%), Iris Prolapse (3.8%), Vitreous Loss (2.2%), Incomplete capsulorhexis (1.8%), Posterior capsular rupture occurred in 1.2% of cases.,Across 500 cataract surgeries, posterior capsular rupture occurred in 6 cases, corresponding to a total incidence of 1,2%. The incidence of incomplete capsulorhexis in the following table does not have a specific pattern. During the initial 100 cataract cases, 6 vitreous loss events occurred, each associated with posterior capsular rupture and anterior vitrectomy. Following the 400^th case, two additional cases occurred due to zonular dialysis combined with anterior vitrectomy. 

Intra-operative Iris prolapses occurred in 19 cases (3.8%). 10.0 nylon sutures were used in 39 cases overall (7.8%), of which 14 (73.7% of iris prolapse cases) were placed to secure wounds following iris prolapse.

During the initial cataract cases the complication incidence was higher compared with cases from 100-400. From 400-500 a high incidence increase can be observed due to the complexity level. This audit aims to educate all resident doctors about complication rates in early stages of cataract surgery. Number of complication gradually decrease as experience increases.